Information Collection

Chemical Exposure Question Bank

IC 206442 under ICR 201304-0923-001 · OMB 0923-0040.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att 2.Revised_Library of Chemical Exposure Questions_0923-0040.doc	Other-WORD
Att 2.Revision Abstract_0923-0040.doc	Other-WORD
Chemical Exposure Question Bank Attachment 3 Chemical Exposure Question Bank _20130326.doc	Form and Instruction
Att 7. Revision_Comparison_ Exposure Investigation Library_0923-0040.doc Att 7	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD			Att 2.Revised_Library of Chemical Exposure Questions_0923-0040.doc	Yes	No	Fillable Printable
Other-WORD			Att 2.Revision Abstract_0923-0040.doc	Yes	Yes	Fillable Printable
Form and Instruction	none	Chemical Exposure Question Bank	Attachment 3 Chemical Exposure Question Bank _20130326.doc	Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title: 09-19-001 Records of Persons Exposed or Potentially Exposed to Hazardous or Toxic Substances (ATSDR)

FR Citation: 57 FR 62814

Number of Respondents: 1,200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	600	600
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att 7	Att 7. Revision_Comparison_ Exposure Investigation Library_0923-0040.doc	07/07/2009

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.